Fentanyl Addiction During Pregnancy: How Keeping Her Baby Saved Them Both.
In her eighth month of pregnancy and suffering, the expectant mother visited the medical facility after an infection began spreading up her legs. Unemployed and homeless, estranged from her family, she lived in a shed she had constructed in a companion's property. She was also dependent on fentanyl.
As physicians addressed her infection, she started to feel anxious. Withdrawal was setting in. She slumped forward and became sick.
Stephanie finally broke down. “I need to leave. I have to go home and use drugs.”
She had taken the drug before seeking medical help and had only a brief window to get treated before she needed to go home to relapse. She thought she still had a month remaining to figure out how to get clean and deliver her child.
The medical professional intervened. She told Stephanie she was staying put.
“Yes, I am,” Stephanie said.
But the medical facility declined to release her: the condition in her limbs was serious, but medical staff detected she also had an ruptured membrane. The nurse, Izzie, warned her: if she left, she and her baby would not survive.
She encouraged the doctor to give Stephanie measured quantities of fentanyl periodically, knowing that withdrawal could endanger her and the baby. Post-birth Stephanie would be switched to methadone, a drug that alleviates cravings and is frequently utilized in substance abuse treatment.
Five days later, on a day in November 2022, Stephanie had a infant weighing just over four pounds – born before term, small but alive.
When the nurse asked if she wanted to hold her baby, Stephanie said “I cannot.” She was numb. Her pain relief did not work, her last dose of fentanyl had been administered a few hours prior to birth.
She felt unwell. Unprepared to be a mother. Not fit.
Stephanie had tried to get clean multiple times while expecting, and felt awful each time she was unsuccessful. She felt hopeless, blaming herself for not being able to achieve the unattainable. An doctor told her to “simply” stop using. Even her dealer refused to sell to her when she became obviously with child.
“However, I failed,” she said. “I required assistance.”
The common assumption that her love for her baby would make her stop using only led to greater shame and self-harm, a impetus for her to relapse. Yet she could not just wish her addiction away, any more than she could overcome a chronic disease.
The baby was taken to the NICU. When Stephanie finally saw her her, she was attached to monitors, so small she thought she would harm her. Embracing her at last, she felt nothing. “I looked at her and was like, ‘What am I going to do with you?’” She still wasn’t sure she wanted to be her mother.
Two days later she decided to give her child the name Izzie, after the professional who provided support to her.
Nurses and doctors told her about a care center, a unique recovery environment where women and their babies are treated together, not apart.
In numerous states, where a baby is found to have newborn addiction symptoms every 18 minutes, infants are still rushed to special care and given drugs while their mothers face child-protection investigations. But a developing system of centers like this facility is proving a simple point: when mothers and babies stay together, recovery succeeds, custody cases decrease and long-term costs decline.
It took Stephanie a while to gather the courage to call, but she eventually made the call. After verifying her eligibility for the program, two staff members came to collect her.
She departed the institution still in detox, scared and uncertain about what would come next.
At the facility, Stephanie still was concerned that authorities would come take Izzie – even though she was uncertain about motherhood. The anxiety remained: that at any time, someone could arrive and take her baby away.
For the initial fortnight, Stephanie remained isolated. “I preferred to be alone,” she said. “I lacked confidence at that point.”
Survival outdoors, she said, was about getting by. Addiction came first; reliance came last.
Stephanie had a trusted ally, but even that connection was tenuous. The those close to her always found ways to let her down. She did not know how to care for herself, much less anyone else.
Each day, staff from the center transported her to a recovery program, administered in pill form. Slowly, she was starting to get clean.
She spent every minute beyond therapy with Izzie, and could see that her baby was obtaining necessary support she needed. Her girl had some trouble feeding at first, with adverse reactions to milk and pronounced gastrointestinal issues. She needed dietary support. She also had sensory challenges and required an specialist – all common issues for babies born with NAS.
If this little kid could see that these babies deserve to be loved, then I found the strength. I could be a mom.
On a day prior to the holiday, Stephanie remained in the shared space, where individuals struggling with substance use can come for monitored interactions with their babies. An advocate, a mentor, stopped by with her own five kids in tow to deliver baked goods. They all assembled beside Stephanie, who was resting on the carpet holding Izzie.
The young ones stared in wonder of the little newborn in Stephanie’s arms. “They were innocent,” Stephanie said. “My past did not matter to them. Such issues were irrelevant.”
She keeps a photo of the moment. She is clad in black pants and a hoodie, a gray knit hat with a pompom on her head, seated on the ground with the door behind her. She is thin. Her posture is humble so you miss her features. She is holding Izzie up on her leg for the other kids to see and they are standing close, fawning and reaching out to the baby.
A young boy, eight, asked the moms: “What about the fathers?” The women attempted to clarify that the men were occupied, engaged elsewhere, that they would be there if they could.
“Once I become a parent,” Jacob said, “I plan to be a great parent. I’m gonna show them that they deserve to be loved.”
Stephanie and her companion exchanged glances. “I became emotional,” Stephanie said. “Seeing that even youth understand that newborns require care, then I found the courage. I could be a mom.”
Methods to address infants affected by substances have been available for years.
The Finnegan NAS scale was established in 1975|
